This open education resource (OER) textbook was designed around the laboratory manual used by the faculty at Thompson Rivers University (TRU) Health Care Assistant program (Christianson, T., & Morris, K., Chardon, J., Flurey, L., & Nordick, L.(2022). TRU Health Care Assistant Program HEAL 1150 Healing 3: Personal Care and Assistance Course Manual. Thompson Rivers University. It was enhanced with resources and materials from other OERs that are noted below.
The OER is founded on best-practices related to the competencies and skills for health care assistant (HCA) students, specifically in HCA programs following the British Columbia Provincial curriculum http://solr.bccampus.ca:8001/bcc/items/e4e61b7e-6615-436e-9cf1-ce808dce5c63/1/. However, the content covered within this textbook can be applied to most HCA program curriculum and offers students the opportunity to acquire personal care and assistance skills within the parameters of the HCA role. The content helps the student learn the theoretical principles and concepts along with understanding the steps of practical skills required to maintain and promote the comfort, safety and independence of individuals in community and facility contexts.
British Columbia Provincial Curriculum (2015) Educational Outcomes
1. Perform personal care skills in an organized manner ensuring the comfort and appropriate independence of the client:
- Organize and implement safe care according to client needs. Encourage independence of the client as much as possible.
- Encourage client communication and engagement during personal care. Maintain client privacy and dignity.
- Assist the client with personal hygiene and grooming. Assist the client with movement and ambulation.
- Use aids to promote comfort, relaxation and sleep.
- Take and record vital signs accurately (temperature, pulse, respirations). Assist the client to meet nutritional needs.
- Assist the client with medication.
- Provide specialized, sensitive care for the dying client in line with palliative care principles.
2. Apply an informed problem-solving process to the provision of care and assistance:
- Assess the client and situation.
- Observe changes in the client’s health status.
- Set priorities or make adjustments to the care process based on client requirements.
- Identify priorities for care within the care plan.
- Utilize appropriate health team members as resources to augment one’s own problem-solving and decision-making.
- Follow the care plan for each client. Conduct care-giving or assisting activities.
- Reflect on and evaluate effectiveness of care or assistance. Carry out recording requirements.
- Utilize creativity when required to adapt care and assistance to a variety of contexts.
3. Provide personal care and assistance within the parameters of the HCA:
- Comply with legal/employer-defined parameters of practice for HCA roles.
- Collaborate with other members of the health team.
- Use appropriate lines of communication.
- Demonstrate dependability, reliability, honesty and integrity. Safely Adhere to the client’s care plan.
4. Provide care and assistance in ways that maintain safety for self and others in a variety of contexts:
- Wear safe and appropriate clothing, including identification. Assess the environment prior to commencing care.
- Adjust the environment, as appropriate, to ensure safety and to promote efficiency.
- Organize time and equipment for safety and efficiency.
- Base choices and actions on a sound knowledge of asepsis and body mechanics. Adhere to infection control practices.
- Recognize and make wise choices in situations of potential risk to self or others. Exhibit flexible and adaptable behaviour in a variety of contexts.
- Recognize and respond appropriately to emergency situations.
Adaptations
List of OERs Used:
Alberta Health Services. (2022). Medication Assistance Program (MAP) manual. https://www.albertahealthservices.ca/assets/info/seniors/if-sen-map-program-in-alberta.pdf adapted with permission
Alberta Health Services. (2016). Health care aide role in medication assistance: A Companion to the
Alberta provincial continuing care Medication Assistance Program (MAP) manual. https://pdf4pro.com/cdn/health-care-aide-role-in-medication-assistance-27c3.pdf adapted with permission
Anderson, R., Rees, G., & McCutcheon, J. (n.d.). Clinical procedures for safter patient care – Thompson Rivers University Edition. https://pressbooks.bccampus.ca/clinicalproceduresforsaferpatientcaretrubscn/
Ernstmeyer, K., & Christman, E. (Eds.) (2021). Nursing skills – Chippewa Valley Technical College. https://wtcs.pressbooks.pub/nursingskills/
Girdi-Papp, M. (2022). Comparative Oral+ENT Biology. Comparative Oral+ENT Biology : Marcos Gridi-Papp : Free Download, Borrow, and Streaming : Internet Archive . Chpt 20 pg 438-450. CC BY 4.0
Interior Health, Home Support Transformation. (2017). Community Health Worker medication competency program: Course manual. Unpublished with Permission to adapt
McLain, K., O’Hara-Leslie, E., & Wade, A. (n.d.). Foundations for assisting in home care. Foundations for Assisting in Home Care – Open Textbook (geneseo.edu)
Provincial Infection Control Network of British Columbia [PICNet]. (2014). Infection control quick-reference guide for residential care facilities (Volume 2) [PDF]. PHSA. https://www.picnet.ca/resources/rescarebooklet/ www.picnet.ca/practice-guidelines
Unit 1:
No OER used
Unit 2:
Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon
- Added “terms to know”
- Checklist 1 now Checklist 2.4.1 with no changes to attributions
Provincial Infection Control Network of British Columbia [PICNet]
- 2.2 – Infections used except ‘vaccinations’
- All attributions updated
- Eliminated Alcohol based hand rub section
Unit 3:
Adapted from Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon
- reorganized section to have Musculoskeletal Injuries come after Principles of Body Mechanics.
- Added information re: maintaining proper body mechanics, Patient handling injury prevention and Musculoskeletal Injuries (potential health effects, prevention and treatment)
- Deleted critical thinking exercises
Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie
- Used “Maintaining Proper Body Mechanics” from Chapter 10 “ Care of the Home and Personal Belongings “ Unit C “Ways to Be Safe and Save Entergy and Time”
Unit 4:
Foundations for Assisting in Home Care – Unit B / McLain, Wade, & O’Hara-Leslie
- Added “Terms to Know”
- Changed “Home Health Aide/Personal Care Aide” to “Health care assistant”
- Omitted procedure steps for tasks
Unit 5:
Adapted from Occupational therapy Assistant Student Resource – Used “Patient body Positions” from slide #21; notes section and Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon
- Some wordsmithing of introductory paragraph and body position descriptions.
- Removed information re: children and post-partum women.
- Combined descriptions of bed positions from both OERs.
- Added pictures of position types.
Bedmaking Procedures adapted from Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie
- Procedures re-organized into a table format with ‘Steps’ and ‘Rationale’ columns.
- Rationale added to some steps
- Added procedure table re: ‘How to Mitre a Corner” with photos.
- Videos added after procedure tables.
Unit 6:
Comparative Oral+ENT Biology, Girdi-Papp
- Sections on swallowing and dysphagia simplified for the target audience
Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie
- Added “Terms to Know”
- Changed “Home Health Aide/Personal Care Aide” to “Health care assistant”
- Formatted procedure steps into procedure tables throughout
Unit 7:
Much of this unit was adapted from Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie
- Added “Terms to Know”
- Added introductory sections: “Normal Urinary Elimination”, “Characteristics of Urine”
- Added “Guidelines” for assisting with urinary elimination.
- Changed title to “Assisting with Urinary Elimination”
- Changed ‘patient’ to ‘client’
- Changed “Home Health Aide/Personal Care Aide” to Health Care Assistant.
- Added picture of assistive devices (Figure 7.2.2)
- Procedures re-organized into a table format with ‘Steps’ and ‘Rationale’ columns.
- Added picture of condom catheter and urinary drainage bag (7.2.3,7.2.4)
- Added videos for each procedure
- Using a Bed Pan
- Using a Urinal
- Applying a Condom Catheter
- Providing Perineal Care with an Indwelling Catheter
- Emptying a Urinary Drainage Bag
- Added pictures (7.2.5, 7.2.6) depicting drainage bag position and emptying the drainage bag
- The statement “if required by care plan” added to procedure step “Lower the bed to its lowest setting and ensure side rails are raised”
- Changed “nurses” to “Health care Assistants”
- Utilized check list 47: Medication Administered Rectally
- Changed title to: Procedure: Medication Administered Rectally
- Changed “patient” to “client”
- Adapted some steps to be appropriate to HCA level
- Figure 7.3.7 has been replaced
- “Procedure: Changing an Ostomy Appliance (flange and pouch)
- Changed “patient” to “client”
- Information adapted to level of HCA role
Section 7.5 Ostomies: Adapted from Nursing Skills – Chippewa Valley Technical College
- information adapted to level of HCA role
- Physical and emotional Assessment; Urostomy care removed
Unit 8:
Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon
- Omitted learning Objectives 1-3
- Added “Terms to Know”
- Omitted sub-section 3.23.2
- Omitted link to “Interior Health Patient Handling Procedure: One person manual
- Omitted link to “Safe Patient Handling Assessment Form from Winnipeg Health Region
- Checklist 1 now Checklist 2.4.1 with no changes to attributions
- Table 3.7 now Table 8.1.1 with bullet 7 omitted
- Checklist 24 now Checklist 8.2.1
- Checklist 27 now Checklist 8.3.1
- Table 3.5 now Table 8.5.1
- Checklist 26 now Checklist 8.6.2
- Table 3.4 now Table 8.7.1
- Table 3.6 now Table 8.9.1
- Updated links for PHSA courses
- Updated link for Mobility Decision Support Tool link
- Updated link for Lateral Transfer Sliding Board
- Changed “residential” to “long-term care
- Added the sentence, “In British Columbia, the British Columbia Patient Safety and Learning System is used.”
Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie
- Changed “home health aide/personal care aide” to “HCA”
Unit 9:
Section 9.2 Adapted from Chapter 11 “Oxygen Therapy” in Nursing Skills – CHIPPEWA VALLEY TECHNICAL COLLEGE
- Learning objectives deleted
- Added 3 sentences Oxygen is considered a medication and, therefore, requires a prescription and continuous monitoring by the RN/LPN to ensure its safe and effective use. As a Health Care Assistant, your role is to provide safe care to clients who are receiving oxygen therapy. Depending on your facility/agency, you may be trained to provide oral suctioning and transfer a client’s oxygen source from a liquid cannister to an oxygen concentrator or portable cylinder
Section titled “Cautions with Oxygen Therapy ” adapted from Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon
- Changed ‘patient’ to ‘client’
- Table 9.2.1 Oxygen Safety Guidelines for Home and Hospital added in additional information regarding ordering of ABGs “This is not the responsibility of the Health Care Assistant”
Section 9.3
- Table 9.3.1 Adapted from Nursing Skills – CHIPPEWA VALLEY TECHNICAL COLLEGE
- Created from information in Chapter 11, section 11.3 “Oxygenation equipment”.
- “Patient” changed to “client”
- Table 9.3.2 Adapted from Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon
- Title changed to “Types of Oxygen Tubing and Equipment
- “patient” changed to “client”
- Figure 9.3.5 replaced “nasal cannula” figure
- Figure 9.3.6 replaced “simple face mask” figure
- Figure 9.3.7 replaced figure 5.1
- Figure 9.3.10 replaced Figure 5.2
- Figure 9.3.11 replaced figure 5.3
- Video added: Oxygen Therapy
Section 9.4
Adapted from Nursing Skills – CHIPPEWA VALLEY TECHNICAL COLLEGE
- Information removed linking to previous sections of textbook
- ‘patient’ changed to ‘client’
- “patient and/or nurse” changed to “client, nurse and/or Health Care Assistant”
- “BiPAP” title changed to “Bilevel Positive Airway Pressure (BiPAP)
- Reference to image removed as image not utilized.
- Video “Using a CPAP” added
Adapted from Vital Sign Measurement Across the Lifespan – 2nd Canadian Edition
- “registered Nurse” changed to “Health Care Assistant”
- Under “Infection Prevention and Control” content removed re: hand gel and handwashing – Instead, readers are directed to review this content in Unit 2: Infection control
- Videos and H5Ps removed
- “Pain Assessment” section removed
- “Significance of Measurements” section changed to acknowledge the role of the Health Care Assistant in vital sign measurement.
Adapted from Vital Sign Measurement Across the Lifespan – 2nd Canadian Edition
- Figure 9.6.1 replaced figure 2.1
- “Healthcare provider” changed to “LPN/RN” or “Health Care Assistant”
- H5Ps removed or put at end of Section
- Reference to “OER #2” removed
- “Points to Consider” re: newborns and infants removed
- Clarification of the HCA role added .
- Summary changed to clarify the role of the Health Care Assistant and LPN/RN in measuring temperature.
Adapted from Vital Sign Measurement Across the Lifespan – 2nd Canadian Edition
- Reference to OER#1 and OER #2 removed
- “Points to consider” re-written to clarify role of HCA and LPN/RN
- Information related to assessment of findings removed
- “Health Care provider” changed to “Health care Assistant”
- Information re: use of doppler device removed
Adapted from Vital Sign Measurement Across the Lifespan – 2nd Canadian Edition
- Reference to OER#1 and OER #2 removed
- Wording changed to clarify role of HCA and LPN/RN
- Clarification of HCA, LPN/RN role added
Section 9.10
Adapted from Vital Sign Measurement Across the Lifespan – 2nd Canadian Edition
- Reference to OER#1 and OER #2 removed
- Content related to infants and children removed
- Points to consider regarding SP02 and hypoxic tissue injury removed
- Reference to arterial lines removed
- Figure 4.1 replaced with figure 9.9.1
- Figure 4.2 replaced with figure 9.9.2
- Figure 4.3 removed
- Clarification of HCA, LPN/RN role added
- “Points to consider” removed
- Chapter summary re-written to address changes made and HCA/LPN/RN role
Adapted from Vital Sign Measurement Across the Lifespan – 2nd Canadian Edition
- Reference to OER#1 and OER #2 removed
- Clarification of HCA, LPN/RN role added
- Points to consider regarding taking BP in both arms for first time removed
- Factors that Influence Blood Pressure section not included
- Most Information related to manual BP deleted.
- Chapter summary re-written to reflect HCA/LPN/RN role
Adapted from Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie
- Changed Home Health Aide/Personal Care Aide to Health Care Assistant
- Added “height” to introductory sentence
- Changed “patient” to “client”
- Procedure “weighing a client” changed to a table
- Added procedure “Measuring a client’s height in bed”
- Figure 1.2.4 replaced with Figure 9.11.1
- Explanation of BMI table changed to fit kg/metres.
Unit 10:
Clinical Procedures for Safe Patient Care / Anderson, Doyle, & McCutcheon
- Added “Terms to Know”
- “While the HCA does not need to know the exact purpose of the tube, you should know the location of the tube to understand what to expect” was added.
Unit 11:
Adapted from Foundations for Assisting in Home Care / McLain, Wade, & O’Hara-Leslie
- Changed Home Health Aide/Personal Care Aide to Health Care Assistant
- Chapter re-arranged
- U.S. statistics re: unintentional injuries replaced with Canadian statistics.
- Community resources section added
Unit 12:
Interior Health. (2017). Interior Health Home Health Unregulated Care Provider
- Updated image attributes with Creative Commons Licensed images
- Changed “Community Health Worker/CHW” to “Health care assistant/HCA”
- Definitions used with definitions added
- Team involved changed “LPN supervisor” to “supervisor”
Alberta Health Services, Medication Competency program. Adapted with permission.
- “unregulated healthcare provider” changed to “health care assistant”
- Changed the “7 Rights” to “6 Critical Rights”
- Used the Examples 1 & 2 Attributes
- Medication Record – changed “regulated health care provider” to “nurse”
- Changed “HS Service Plan” to “care plan”
- Additional quiz questions added
Unit 13:
No OER used
